Chemical Spill or Leak

  1. The time the incident was reported to you
  2. How were you notified of the spill or leak and by whom?
  3. The specific location of the spill or leak.
  4. The type of materials involved (solvents, flammables, etc…)
  5. The extent of any injuries and the number of persons injured.
  6. Did any of the material that spilled or leaked enter a drain?
  7. Whether or not the spill has been contained with absorbing clay or other clean­up material
  8. The time that 9-1-1 was notified and by whom.
  9. The time emergency personnel arrived on scene.
  10. Whether or not the facility was evacuated.
  11. The time you notified client contacts and your supervisor.

 

Environmental Emission

  1. The time the incident was reported to you
  2. How were you notified of the incident and by whom?
  3. The specific location of the emission.
  4. The source of the emission (material or chemical)
  5. Extent of injuries and number of persons injured.
  6. The time you notified client contacts and your supervisor.
  7. The time that 9-1-1 was notified and by whom.

Weather-Related Events

  1. Any damage done to the property.
  2. The time you notified client contacts and your supervisor.
  3. The time that outside services were notified to remove tree limbs, restore power, etc…
  4. The extent of any injuries and the number of persons injured.
  5. The time 9-1-1 was notified.
  6. The total number of persons in the building.
  7. Advise of ability for extra security personnel to report on duty.

Assault/Domestic Dispute At Work

  1. The time the incident was reported to you
  2. How were you notified of the incident and by whom?
  3. The specific location of the incident.
  4. The names of the persons involved.
  5. The extent of any injuries and the number of persons injured.
  6. If known, identify the type or kind of weapons involved.
  7. If known, identify any hostages.
  8. The time that 9-1-1 was notified and by whom.
  9. The time emergency personnel arrived on scene.
  10. Whether or not the facility was evacuated.
  11. The time you notified client contacts and your supervisor.

Osha Inspection

  1. The time the OSHA officer arrived on the scene.
  2. How were you notified of their arrival?
  3. The specific location of the inspection.
  4. Was the OSHA officer asked to provide proper photo identification?
  5. The time you notified client contacts and your supervisor

Theft

  1. What time was the theft reported to you?
  2. How were you notified of the theft and by whom?
  3. The specific location of the theft.
  4. Type of property involved (personal or com­pany)
  5. Identification of the property (such as color, size, model and serial number, weight, if a vehicle obtains make, model, year, color and license number).
  6. The names of any witnesses.
  7. The names of any possible suspects.
  8. If the police are involved, the time that the police were notified.
  9. The time the police arrived on the scene.

The time you notified client contacts and your supervisor